This article examines the emergence of hand replantation surgery in socialist China to rethink the relationship between industrialization, medicine, and Cold War technopolitics. Developed in response to rising workplace amputations during the Great Leap Forward, hand replantation became more than a surgical technique confined to the operating room. Drawing on medical journals, propaganda materials, and municipal archives, the article argues that replantation functioned as a "remediating" practice that repaired injured bodies while mediating the social ruptures of accelerated industrialization. Surgeons, workers, transportation systems, and improvised materials formed "chains of rescue" linking bodily trauma to socialist ideals of labor protection and collective mobilization. Hand replantation also crossed geopolitical divides-shifting from the Sino-Soviet split to Third World medical aid and Sino-U.S. scientific exchange. By tracing surgery across bodily, social, and geopolitical scales, the article argues that technopolitics emerged through situated technical practices as much as through state systems and ideology.
This article uses the global trade in Chinese egg products to rethink the history of refrigeration beyond narratives of technological diffusion and thermal colonialism. Tracing the rise of China's egg-processing industry in the treaty ports, it argues that refrigeration functioned not simply as a colonial technology but as an infrastructure through which states, firms, and consumers negotiated questions of hygiene, trust, and market power. British and American companies introduced refrigerated production systems that Chinese enterprises selectively adapted, while the rapid expansion of low-cost exports provoked protectionist campaigns and sanitary disputes in Europe and the United States. "Chinese eggs" became a political and cultural problem through which anxieties about industrial food, racial difference, and international competition were expressed. As export markets contracted during the interwar crisis of the twentieth century, refrigeration expanded into China's domestic economy through cold storage, logistics, and mass consumer culture. The article shows how refrigeration reshaped both global food politics and everyday urban life in modern China.
Extraintestinal pathogenic Escherichia coli (ExPEC) can colonize and infect body sites outside the intestines, which can lead to invasive E. coli disease potentially resulting in sepsis or death. We evaluated O-serotype distribution, antimicrobial resistance profiles, and sequence types (STs) of ExPEC bloodstream isolates collected during 17 global surveillance studies conducted from 2011 through 2023. E. coli clinical blood isolates from an adult population were analyzed for O-serotype, ST, and multidrug-resistance (MDR) using data obtained by agglutination, whole-genome sequencing, and determination of minimal inhibitory concentrations of antimicrobial drugs. Globally, 10 098 E. coli isolates were collected; 4925 (48.8%) from men and 5136 (50.9%) from women, median (range) age was 72 (18-104) years. The most prevalent ExPEC O-serotypes were O25 (18.7%), O2 (8.2%), O6 (8.2%), and O1 (7.0%). Highest MDR rates were observed in India (83.3%), Mexico (76.6%), and China (69.4%); lowest rates were in Sweden (10.6%), New Zealand (11.6%), and Netherlands (12.1%). Among MDR isolates (n=3343), serotype O25 was the most prevalent in all countries (range: 11.3% China to 56.2% Mexico). We observed a resistance rate of 1.1% and 0.7% to last-resort carbapenem and colistin antibiotics, respectively, distributed over diverse STs and O-serotypes. Overall, serotypes O25, O2, O6, and O1 were the most prevalent. MDR levels showed large regional variation. O25 was dominant within the subset of MDR isolates across all countries. O153-ST648, O101/O162-ST744, O102-ST405, and O25-ST131 were associated with MDR.
The mode of reproduction is a key aspect for an organism to adapt to its environment. However, understanding the reproductive strategies in extinct animals from deep time remains challenging, due to the scarcity of fossils providing such information. Although viviparity is well-documented across various ichthyosaur lineages, our understanding of the reproductive characteristics of early-diverging Triassic taxa is still limited, particularly regarding their litter sizes. Here, we describe an exceptionally preserved gravid specimen of the Middle Triassic ichthyosaur Mixosaurus from southwestern China, containing at least eleven fetuses. This represents the largest litter sizes ever recorded in a Triassic ichthyosaur, and even one of the highest numbers of fetuses known in all ichthyosaurs. The well-articulated fetal skeletons exhibit consistent developmental stages and advanced ossification, indicating a late prenatal or perinatal state. Their variable body orientations further suggest the absence of a fixed head-first or tail-first birth posture. The presence of over ten fetuses in Mixosaurus demonstrates that high fecundity, potentially indicative of a more r- than K-selection reproductive strategy, had evolved early in ichthyosaur evolutionary history. This reproductive trait may have been a significant factor contributing to the success of this ichthyosaur group with enormous populations and widespread distribution across Northern Hemisphere during the Triassic.
Contaminated environmental surfaces contribute to the transmission of pathogens that cause healthcare-associated infections. The present study aimed to assess the efficacy and cost implications of a chlorine-based combined detergent-disinfectant used for environmental decontamination around methicillin-resistant Staphylococcus aureus (MRSA) patients. The study was conducted over a six-month period in the inpatient wards (medical, surgical, and orthopedic) of Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region, People's Republic of China. The surrounding areas of newly diagnosed MRSA patients were divided into two equal halves and decontaminated using either the conventional two-step process (cleaning with detergent followed by disinfection with a 1000 ppm hypochlorite solution) or a new one-step method using a combined detergent-disinfectant. High-touch surfaces in the patients' immediate environment were sampled before and after decontamination to detect MRSA by culture and to measure adenosine triphosphate (ATP) levels. The number of disposable wipes used and the duration of the decontamination process were recorded for the cost analysis. Both the conventional and the new methods significantly reduced the MRSA detection rate from 68.7% to 12.7% and to 15.3%, respectively (p < 0.001), and significantly reduced the ATP failure rate from 78.2% to 2.7% and to 4.5%, respectively (p < 0.001). Compared with the conventional method, the new method saved an average of 5.9 minutes of decontamination time and 10.2 disposable wipes per patient, resulting in a substantial cost saving of over 6 million Hong Kong dollars per year according to current infection control recommendations for MRSA patients in public hospitals in Hong Kong. The one-step method using a combined detergent-disinfectant effectively decontaminated high-touch hospital surfaces in the patient environment while reducing both time and costs. Its broader implementation in local inpatient settings may enhance environmental hygiene while reducing costs.
A cross-linked ionic conducting elastomer with multiple dynamic bonds is prepared via in situ polymerization to achieve fast Li+ conduction and self-healing during operational cycling. The resulting LiFePO4 full cells achieve 3000 and 1200 cycles at high rates of 5C and 10C, respectively.
Multiple mitochondrial dysfunction syndrome type 3 (MMDS3; OMIM #615330) is a rare autosomal recessive disorder caused by mutations in IBA57. Its complex clinical presentation and molecular pathogenesis remain incompletely understood. The study included comprehensive clinical evaluation, IBA57 genetic testing, Western Blotting for protein expression, and transcriptomic and metabolomic analyses of amniotic fluid cells. The proband presented with typical MMDS3 features, and both affected siblings carried compound heterozygous IBA57 missense mutations (c.310G>T and c.826C>T) leading to reduced IBA57 protein expression. RNA-seq revealed transcriptional dysregulation of the PI3K-Akt signaling pathway, and metabolomics demonstrated TCA cycle disturbances in amniocytes. Respiratory chain enzyme assays showed a selective deficiency of complex II activity in fetal liver. The compound heterozygous IBA57 mutations c.310G>T and c.826C>T lead to reduced IBA57 protein expression, selective impairment of respiratory chain complex II, and transcriptional dysregulation of the PI3K-Akt pathway, together contributing to the MMDS3 phenotype in the proband and the affected fetus.
Placental abruption is a serious complication in pregnant women with preeclampsia. This study investigated the risk factors for placental abruption and developed a predictive model using the Synthetic Minority Over-sampling Technique (SMOTE). A total of 280 pregnant women with preeclampsia treated between September 2020 and September 2025 were enrolled and classified into placental abruption and non-placental abruption groups. Logistic regression showed that parity ≥3, severe preeclampsia, anemia, polyhydramnios, and short umbilical cord were independent risk factors for placental abruption. ROC analysis demonstrated that the SMOTE-based model had better predictive performance than the original model, with a higher AUC (0.863, 95% CI: 0.817-0.901 vs 0.792, 95% CI: 0.739-0.838; z=2.163, P=0.031). The SMOTE-based model also showed higher F-score and positive predictive value, although its true positive rate was lower than that of the original model. These findings indicate that a SMOTE-based predictive model may provide useful support for early risk assessment and prevention of placental abruption in women with preeclampsia. L'hématome rétro-placentaire (ou décollement prématuré du placenta) est une complication grave chez les femmes enceintes atteintes de prééclampsie. Cette étude a examiné les facteurs de risque de cette complication et a élaboré un modèle prédictif utilisant la technique SMOTE (*Synthetic Minority Over-sampling Technique*). Au total, 280 femmes enceintes atteintes de prééclampsie, prises en charge entre septembre 2020 et septembre 2025, ont été incluses et réparties en deux groupes : celles ayant présenté un hématome rétro-placentaire et celles n'en ayant pas présenté. La régression logistique a révélé qu'une parité ≥ 3, la prééclampsie sévère, l'anémie, le hydramnios et un cordon ombilical court constituaient des facteurs de risque indépendants d'hématome rétro-placentaire. L'analyse des courbes ROC a démontré que le modèle basé sur la technique SMOTE offrait de meilleures performances prédictives que le modèle initial, avec une aire sous la courbe (AUC) plus élevée (0,863 ; IC à 95 % : 0,817–0,901 contre 0,792 ; IC à 95 % : 0,739–0,838 ; z = 2,163 ; P = 0,031). Le modèle basé sur SMOTE présentait également un score F (*F-score*) et une valeur prédictive positive plus élevés, bien que son taux de vrais positifs fût inférieur à celui du modèle initial. Ces résultats indiquent qu'un modèle prédictif basé sur la technique SMOTE pourrait constituer un outil utile pour l'évaluation précoce des risques et la prévention de l'hématome rétro-placentaire chez les femmes atteintes de prééclampsie.
Target-triggered catalytic hairpin assembly lights up darkish DNA-templated silver nanoclusters through proximity-induced activation by a G-rich fluorescence enhancer. Beyond being label-free, this lighting-up fluorescence biosensor requires neither quenchers nor separation steps, greatly simplifying the operation.
Ten prenylated acylphloroglucinols were obtained from the whole herb of Hypericum scabrum, four of which (1-4) are undescribed compounds. Structural identification was accomplished by extensive spectral analyses including HRESIMS, 1D and 2D NMR, DP4+ combined with 13C NMR quantum calculation as well as ECD simulation. Subsequent cytotoxic and neuroprotective activity assays revealed that all compounds except 4, 8, and 9 exhibited moderate cytotoxicity against Cal-27 cells, with compound 1 displaying the strongest activity (IC50 = 21.29 ± 0.03 µM). At varying concentrations, all tested compounds exerted certain protective effects against corticosterone-induced damage to PC12 cells, with compound 9 showing the strongest protective activity. These findings underscore the dual cytotoxic and neuroprotective potential of prenylated acylphloroglucinols from H. scabrum, highlighting their promise as candidates for human health and therapeutic development.
Thoracic aortic dissection (TAD) is a highly lethal disease without effective drug therapy. Guidelines recommend control of risk factors, particularly of causal hypertension. Antihypertensive drugs are diverse in mechanisms of action, but no randomized controlled trials have been undertaken to evaluate their efficacy and safety, and guide rational drug selection for this disease. Antihypertensive drugs were evaluated in a 3-aminopropionitrile-induced mouse model of TAD. Pharmacovigilance analysis using the FDA Adverse Events Reporting System and Medical Information Mart for Intensive Care databases, along with a systematic meta-analysis of 32 studies, was performed to assess drug-associated risks in aortic diseases. Signaling pathways related to smooth muscle cell contractility, adhesion, and cytoskeleton stabilization were examined in human and mouse tissues. A chemogenetic mouse strain with smooth muscle cell-specific expression of the pharmacologically selective actuator module 4-serotonin type 3 receptor channel was generated to modulate Ca2+ signaling. Here, we assessed 8 classes of antihypertensives in a mouse TAD disease model but unexpectedly observed that hydrochlorothiazide and minoxidil exacerbated the disease. Pharmacovigilance analysis linked diuretic use to an increased TAD-associated risk in patients. TAD pathogenesis and the harmful drug effects are attributable to blunted Ca2+-dependent smooth muscle cell contractility and adhesion. To this therapeutic end, we leveraged a chemogenetic Ca2+-permeable cation channel (pharmacologically selective actuator module 4-serotonin type 3 receptor) exclusively activated by the clinical drug varenicline. The humanized chemogenetic device boosted smooth muscle cell Ca2+ signaling, potentiated the Ca2+-dependent cellular processes, and protected against TAD and the aggravated phenotype induced by hydrochlorothiazide/minoxidil. This study calls for pharmacovigilance of certain antihypertensives in TAD, and suggests that pharmacologically selective actuator module 4-serotonin type 3 receptor, as a viable means of tuning Ca2+ signaling, holds translational potential for TAD therapy.
Scaphoid fractures still have high rate of nonunion, mainly due to the tenuous blood supply and only primary bone healing. Rigid fixation facilitates this kind of bone healing and is considered as vital as protection of the blood supply. The optimal implant (screw) location should meet the requirements for researcher's biomechanical findings on fracture stability. Raw CT-scanned data of eight volunteers' wrists were imported into Mimics. The 3D scaphoid was segmented out and calculated, then opened in Geomagic Studio. Four fracture planes (proximal, oblique waist, horizontal waist and distal) simulating common broken scaphoid were created. Mimicking scaphoid implants (screws), the longest, the sub-longest, and central and eccentric cylinders perpendicular to each fracture plane were created. Whole and inside-fragmental length, and the relative location of each cylinder were measured and analyzed. The longest (28.5 ± 1.6 mm) cylinder was significantly longer than the sub-longest (25.4 ± 1.4 mm). Several eccentric perpendicular cylinders (so short or cutting out of the scaphoid) couldn't be created. Some proximal inside-fragmental lengths ranged from 3.0 to 5.1 mm. Several central perpendicular cylinders intersected with the longest one. Several central and eccentric perpendicular cylinders were outside of the proximal scaphoid non-contact region. The results of this study showed that scaphoid fracture images from CT scan can be calculated and yield the optimal implant location.
The electrocatalytic reduction of carbon dioxide (CO2RR) is a promising technology for sustainable fuel and chemical production, offering a dual solution for climate change mitigation and carbon resource recycling. Nevertheless, the practical deployment of CO2RR is limited by some inherent bottlenecks, including low product selectivity, high overpotentials, and inadequate long-term stability. Recent investigations have demonstrated that fluorine-related modification possesses distinctive merits to boost CO2RR performance, such as tuning the electronic structure and interfacial microenvironment of catalysts. Most notably, it enables effective stabilization of high-valence active centers and regulation of catalyst dynamic reconstruction under cathodic conditions, offering advantages that can complement or, in some cases, outperform conventional modification strategies. However, fluorine modification also faces challenges, including potential trade-offs between hydrophobicity and mass transport, and limited scalability of current fluorination methods. A specialized review summarizing recent advances remains lacking. To fill this gap and provide a roadmap for rational catalyst design, this review summarizes the state-of-the-art progress of fluorine-modified CO2RR catalysts, including carbon materials, fluorine-doped metal catalysts, and organic substrate-modulated composite catalysts, aiming to clarify the structure-activity relationships. It also outlines the challenges and prospects associated with fluorine modification for CO2RR.
Sulfadimethoxine (SDM) is a widely used veterinary antibiotic. Its residues in food and the environment may cause bacterial resistance and threaten human health. In this study, a novel electrochemiluminescence (ECL) biosensor with signal amplification was developed for the sensitive detection of SDM. A g-C3N4@Au composite was modified on the electrode surface, generating a strong ECL signal with K2S2O8 as the coreactant. Hairpin DNA terminated with ferrocene carboxylic acid (FcA) was self-assembled onto g-C3N4@Au via thiol-gold bonds, causing Fc to quench the electrochemiluminescence signal of g-C3N4. Upon SDM addition, it specifically bound to the aptamer strand, releasing the DNA Walker. The DNA walker then continuously hybridized with the activator strand S1 and was cleaved by the nicking endonuclease Nt.BsmAI, generating a large number of S1. S1 further activated the trans-cleavage activity of CRISPR/Cas12a, which cleaves the hairpin DNA on the electrode, releasing Fc and recovering the ECL signal. By monitoring the ECL intensity change during the "signal-off" to "signal-on" transition, quantitative detection of SDM was indirectly realized. The detection range for SDM is 1.0 × 10-14 to 1.0 × 10-7 mol L-1, with a detection limit of 7.15 × 10-15 mol L-1. The sensor was successfully applied to the detection of SDM in food and water samples. Benefiting from the catalytic cascade amplification involving multiple enzymes, the developed method demonstrated high ultrahigh sensitivity.
NASICON-type NaTi2(PO4)3 (NTP) cathodes hold immense promise for use in sodium-ion batteries but are fundamentally limited by their single-electron Ti4+/Ti3+ redox chemistry and intrinsically sluggish electronic conductivity. Introducing multi-electron redox centers (e.g., vanadium) is a theoretical ideal, yet this is practically hindered by a "synthetic paradox" where mismatched precursor kinetics cause severe cation segregation. Herein, we introduce a two-dimensional (2D) structural chaperone strategy, that is, utilizing a dual-transition-metal (Ti1-xVx)3C2 MXene, to translate atomic-level cationic homogeneity directly into three-dimensional (3D) Na2Ti1-xVx(PO4)3 polyanions. Beyond circumventing phase segregation, this atomic-precision synthesis triggers profound orbital reconfiguration. Strong V 3d-O 2p orbital hybridization collapses the band gap from 1.66 to 0.22 eV and reduces the Na+ migration barrier from 0.57 to 0.31 eV, establishing a synergistic electronic-ionic transport network. Consequently, structural optimization of Na2Ti0.5V0.5(PO4)3 (NTVP) transforms its sodium storage mechanism from a sluggish biphasic reaction into a highly reversible solid-solution process, unlocking sequential V3+/V4+/V5+ multi-electron redox chemistry. NTVP delivers exceptional rate capability (128 and 81 mAh g-1 at 0.05 and 10 A g-1, respectively) and enables a full-cell energy density of 248 Wh kg-1. This work enriches polyanion design, establishing a general MXene-templated platform for atomically precise multi-cation modulation.
Hypoalbuminemia is common among critically ill patients and has been associated with adverse clinical outcomes. However, the prognostic significance of the nadir serum albumin level during hospitalization in patients with spontaneous intracerebral hemorrhage (ICH) admitted to the intensive care unit (ICU) remains unclear. This study aimed to investigate the association between in-hospital lowest serum albumin levels and clinical outcomes in ICU patients with spontaneous ICH. We conducted a retrospective cohort study using pooled data from the Tianjin cohort and Medical Information Mart for Intensive Care IV (MIMIC-IV) database. Adult ICU patients with spontaneous ICH were included. The primary outcome was 28-day all-cause mortality. Multivariable Cox proportional hazards models were used to assess associations between nadir serum albumin during ICU stay and 28-day mortality. Restricted cubic splines (RCS) were applied to examine potential nonlinear relationships. The incidence of 28-day mortality increased from 17.2% in the >35 g/L group to 39.3% in the < 30 g/L group, while 90-day mortality increased from 21.2% to 52.0% (both P < 0.001). Similarly, ICU mortality and in-hospital mortality increased progressively with decreasing albumin levels. In addition, patients with lower albumin levels had significantly longer ICU and hospital stays (both P < 0.001). RCS analyses showed no clear evidence of nonlinearity in the fully adjusted model. Subgroup analyses by mechanical ventilation (MV) status showed that lower albumin levels were associated with increased mortality among patients without MV, whereas these associations were attenuated among those receiving MV. Significant interaction by MV status was observed for in-hospital, 28-day, and 90-day mortality (all P for interaction < 0.05), but not for ICU mortality. Lower nadir serum albumin levels during hospitalization are independently associated with increased mortality in ICU patients with spontaneous ICH. The prognostic value of albumin appears to vary by illness severity and treatment intensity, as reflected by MV status. These findings suggest that nadir serum albumin level may be a simple and clinically relevant prognostic marker for risk stratification in this population.
Diabetic foot disease is a major cause of preventable disability, hospitalization, and lower-extremity amputation worldwide, with a disproportionate burden in resource-limited settings. Although major amputation rates have declined in high-income countries through multidisciplinary care, many resource-limited settings still face delayed presentation, fragmented services, limited specialist access, and weak financial protection. Previous reviews have often examined diabetic foot care, digital health, or community interventions separately, with limited attention to how these approaches can be integrated in resource-limited settings and implemented through a health equity lens. This narrative review therefore aimed to examine, from a global health and health equity perspective, how digital health and community-based care may jointly support diabetic foot prevention and management in resource-limited settings, particularly in sub-Saharan Africa (SSA). A structured search of PubMed/MEDLINE, Web of Science, and Scopus, supplemented by relevant policy and guideline sources, identified evidence published between 2005 and 2025. Findings were synthesized across five domains: organized care in high-income settings, structural inequities in SSA, digital health approaches, community-based prevention and early referral, and system-level implementation considerations. Available evidence suggests that digital tools may improve risk identification and continuity of care, while community-based strategies may strengthen prevention and timely referral. However, their effectiveness and sustainability depend on integration with primary care, referral systems, workforce support, financing, and local adaptation. Digital and community-based approaches should therefore be viewed as complementary strategies for strengthening equitable diabetic foot care, rather than as stand-alone solutions.
Biomimetic materials offer a powerful strategy for precise immune modulation by recapitulating natural biological architectures. However, achieving programmable control of immune functions through nanoscale spatial organization remains a significant challenge. Here, we report a class of 3D framework nucleic acids (FNAs) with precisely defined geometries that enable the ordered co-presentation of antigens and immunoadjuvants via a spatial encoding strategy, thereby systematically regulating immune responses. By constructing tetrahedral, triangular prism, and cubic topologies, we demonstrate that geometric configuration plays a critical role in modulating cellular uptake behavior and dendritic cell (DC) maturation. Among these, the cubic structure exhibits superior cellular internalization efficiency and enhanced antigen cross-presentation capability. In lymph nodes, this biomimetic system significantly increases the proportion of CD11c+ CD86+ DCs and promotes MHC class I-dependent antigen presentation, leading to robust activation of CD8+ T cell-mediated immune responses. In tumor-bearing models, this strategy further enhances immune cell infiltration and reshapes the tumor immune microenvironment, resulting in pronounced tumor suppression and improved survival outcomes. Mechanistically, these effects are attributed to a "spatial encoding-driven receptor clustering mechanism," which mimics the multivalent ligand organization of natural pathogens to promote immune activation. Collectively, this study introduces a structure-information-driven biomimetic immunomodulation strategy, offering a new design paradigm for the development of efficient and safe nanovaccines and immunotherapeutic materials.
This review systematically summarizes representative advances in the construction of seven-membered ring compounds via NHC catalysis since 2022. The reported methodologies are categorized into five key strategies based on their reaction modes: a1-to-d1 addition, esterification, Michael addition, vinylogous electrophilic addition, and homoenolate reactions. This review aims to delineate the underlying principles governing this field and to provide a reference for the future development of novel catalytic modes and the synthesis of complex ring systems.
Sc2C is a recently synthesized novel semiconducting electride characterized by electrons residing in well-defined interstitial lattice sites rather than being localized within atoms. While extensive research has been carried out to explore its novel properties, such as reversible, high-capacity hydrogen storage and electrochemical storage, existing literature lacks a precise characterization of its electronic states and thermal transport mechanism, which is a critical prerequisite for a comprehensive understanding of its electronic properties. In this work, we investigate the phonon thermal conductivity (κ) of Sc2C by incorporating the Hubbard U correction to accurately describe its electronic structure using first-principles calculations and the linearized Boltzmann transport equation. We find that the Hubbard U correction significantly enhances κ compared to calculations performed without it. Moreover, we unveil a key competition mechanism: while the Hubbard U correction slightly suppresses four-phonon (4ph) lifetime, it drastically increases the three-phonon (3ph) lifetime. The competition between 3ph and 4ph scattering ultimately leads to the enhanced thermal conductivity. Additionally, the in-plane κ exhibits high sensitivity to boundary scattering at length scales below 200 nm. This work clarifies the role of electronic correlation in modulating the thermal transport properties of electride-based nanodevices.